Basics of Health Management

Dr Arun Mitra

Dept of Community and Family Medicine, AIIMS, Bibinagar

2024-07-01

Learning Objectives

  • Understand the basic concepts of management
  • Explain the fundamental functions of management
  • Discuss Henry Fayol’s principles of management

What is Management?

Definition of Management

  • Over 33 definitions of Management

Simplest Definition

“Getting things done through and with people”

Management is the process of designing and maintaining an environment in which individuals, working together in groups, efficiently accomplish selected aims

Management is a distinct process consisting of planning, organizing, actuating, and controlling performed to determine and accomplish the objectives by the use of people and resources

Why is Management Important in Health?

  • Efficient resource utilization
  • Improved patient care outcomes
  • Enhanced team performance
  • Essential for planning and execution
  • Supports achieving strategic goals

Are Doctors Good Managers?

Theories of Management

  • Management theories are concepts that outline different approaches to management.

  • They guide leadership styles, decision-making processes, and organizational structures.

  • Originated during the Industrial Revolution and have evolved over time.

Classical Management Theory

  • Focus on organizational structure and efficiency
  • Hierarchical approach to management
  • Clear Division of Labor
  • Rationality in Decision-Making
  • Key figures: Henri Fayol, Frederick Taylor, Max Weber

Human Relations Theory

  • Focus on motivating employees, Employee-centric policies
  • Satisfied employees lead to successful organizations

Contingency Theory

Proposes that there is no one best way to manage an organization.

Management practices should be flexible and adapted to the specific situation.

Systems Theory

The Systems Theory perceives an organization as an interconnected and interdependent network of components, focusing on the entire system rather than individual parts.

Basic Principles of Management

Introduction to Henri Fayol’s Principles

  • His work was one of the first comprehensive statements of a general theory of management.

    • six types of organisational activity
    • five primary functions of management
    • fourteen principles of management

Division of Work

  • Specialization increases efficiency
  • Division of labor in healthcare
  • Benefits: Higher efficiency and productivity

Authority and Responsibility

  • Balance of authority and responsibility
  • Clear roles and accountability
  • Decision-making processes

Discipline

  • Importance of following rules
  • Maintaining order and consistency
  • Ensuring reliable performance

Unity of Command

  • One boss for one employee
  • Example: Clear leadership in a healthcare team
  • Image: Leadership clarity
  • Avoiding confusion and conflict
  • Enhancing coordination and efficiency

Unity of Direction

  • Single plan of action
  • Ensuring common goals
  • Alignment of efforts for efficiency

Subordination of Individual Interest

  • Organizational goals over personal interests
  • Example: Team working towards common goals
  • Importance of teamwork
  • Building collective commitment

Remuneration

  • Fair compensation for employees
  • Example: Employee satisfaction and productivity
  • Motivation through rewards
  • Retaining talented staff

Centralization

  • Degree of centralization in decision-making
  • Example: Decision-making in a hospital
  • Balancing power and efficiency
  • Impact on organizational effectiveness

Scalar Chain

  • Clear line of authority
  • Example: Communication flow in an organization
  • Importance of clear hierarchy
  • Ensuring smooth information flow

Order

  • Right person in the right place
  • Example: Organized hospital resources
  • Ensuring efficiency
  • Role of systematic planning
  • Social Order
  • Material Order


Equity

  • Fair treatment of staff
  • Example: Team spirit and fairness
  • Building trust and morale
  • Enhancing organizational loyalty

Stability of Tenure

  • Job security and satisfaction
  • Example: Retention of experienced staff
  • Benefits of stable workforce
  • Reducing turnover and training costs

Initiative

  • Encouraging innovation and proactivity
  • Example: Encouraging innovation in healthcare
  • Importance of creativity
  • Supporting new ideas and improvements

Esprit de Corps

  • Team spirit and unity
  • Example: Team spirit in healthcare
  • Building a cohesive team
  • Enhancing morale and collaboration

Principles of Management

Recap

Definition of Management

managementprocesshumanenterpriseartgoalsobjectivesgroupcontrolplanningpurposesocialresourcesdecisionmakingeffectiveactivitiesdirectorganizationachievecoordinatingdevelopmenteffortinfluenceleadactionsadministratorsagencyaimscarrycentercommunityconcerncreationdatadeterminedirectioneconomicalestablishedfacilitiesfacilitatefulfillmentfunctionguidancehandlingindividualsinitiationintegratingjudgementknowingmajor

Key Takeaways

  • Management Theories

    • Classical Management Theory
      • Focus on structure and efficiency
    • Human Relations Theory
      • Focus on employee motivation
    • Contingency Theory
      • Adaptation to specific situations
    • Systems Theory
      • Focus on the entire system
  • Principles of Management
    • Henri Fayol’s 14 principles


References

  • Fayol, H. (1949). General and industrial management. Pitman Publishing.
  • Koontz, H., & O’Donnell, C. (1955). Principles of management: An analysis of managerial functions. McGraw-Hill.
  • Terry, G. R. (1960). Principles of management. Homewood, IL: Irwin.
  • 14 Principles of Management by Henri Fayol - GeeksforGeeks. Retrieved June 03, 2024, from https://www.geeksforgeeks.org/14-principles-of-management-by-henri-fayol/

Questions?

Thank You!

Management Process

The Managerial Process



P-O-L-C Framework

P-O-L-C Framework

Planning

  • Definition: Setting objectives and determining the best way to achieve them
  • Importance: Provides direction and reduces uncertainty
  • Steps: Analysis, goal setting, action plan, implementation, evaluation
  • Continuous process with feedback loops

Planning requires that managers be aware of environmental conditions facing their organization and forecast future conditions. It also requires that managers be good decision makers.

Process of Planning

  1. Environmental Scanning: Planners must be aware of critical contingencies facing their organization, such as economic conditions, competitors, and customers.
  2. Forecasting: Planners attempt to forecast future conditions, forming the basis for planning.
  3. Establishing Objectives: Objectives are statements of what needs to be achieved and when.
  4. Identifying Alternatives: Planners identify alternative courses of action for achieving objectives.
  5. Decision Making: Planners evaluate alternatives and make decisions about the best courses of action.
  6. Formulating Steps: Planners formulate necessary steps and ensure effective implementation of plans.
  7. Evaluating Success: Planners constantly evaluate the success of their plans and take corrective action when necessary.

Types of Planning

  • Strategic Planning: Analyzing competitive opportunities and threats, strengths and weaknesses of the organization, and determining how to position the organization effectively. It has a long time frame, often three years or more.
  • Tactical Planning: Intermediate-range planning (one to three years) designed to develop concrete means to implement the strategic plan.
  • Operational Planning: Short-range planning (less than a year) specifying ways to achieve organization-wide or subunit goals and objectives.

Organizing

  • Definition: Arranging resources and tasks to achieve objectives

  • Importance: Ensures efficient use of resources

  • Key elements: Division of labor, delegation, coordination

  • Role of organizational charts in clarifying roles

Organizational Structure

  • Framework within which effort is coordinated.
  • Represented by an organization chart.
  • Decisions about the structure are organizational design decisions.

Job Design

  • Involves decisions about duties, responsibilities, and manner of carrying out tasks.
  • Organizational decisions about jobs are referred to as “job design” decisions.

Departmentalization

  • Involves deciding how to cluster jobs into departments.
  • Methods include organizing by function, product, geography, or customer.
  • Larger organizations often use multiple methods.

Designing Individual Jobs

  • Traditional approach based on division of labor and specialization.
  • Recent trend towards balancing specialization with variety and autonomy.
  • Principles include empowerment, job enrichment, and teamwork.

Staffing

  • Recruiting, selecting, and training personnel

  • Ensures right people in right jobs

  • Importance: Maintaining a competent workforce

  • Role of HR in healthcare staffing


  • Example: Hiring and training nurses

Directing (Leading)

  • Leading, motivating, and communicating with employees

  • Importance: Guides team efforts towards achieving goals

  • Effective communication and leadership

  • Ensuring team efficiency and morale

Leading involves the social and informal sources of influence that you use to inspire action taken by others.

Contributions of Behavioral Sciences

  • Personality Research: Understanding subordinates’ personalities, values, attitudes, and emotions is crucial for effective leadership.
  • Motivation Theory: Provides insights into energizing workers to put forth productive effort.
  • Communication Studies: Offer direction on effective and persuasive communication.
  • Leadership Studies: Address questions about what makes a manager a good leader and when certain leadership styles are most appropriate and effective.

Controlling

  • Monitoring and adjusting ongoing activities

  • Importance: Ensures goals are being met, corrective actions taken

  • Steps: Establish standards, measure performance, compare with standards, take corrective action

  • Use of performance metrics to assess outcomes

Controlling Process

  • It consists of three steps:
    1. Establishing performance standards
    2. Comparing actual performance against standards
    3. Taking corrective action when necessary.

Performance Standards

  • Often stated in monetary terms (e.g., revenue, costs, profits) or other terms (e.g., units produced, quality levels).
  • Measurement methods include financial statements, sales reports, production results, customer satisfaction, and performance appraisals.

Managerial Function vs. Behavioral Control

  • Controlling in management does not imply manipulation of subordinates’ personalities, values, attitudes, or emotions.
  • Instead, it focuses on ensuring work-related activities align with organizational objectives.

Relationship with Planning

  • Effective controlling requires clear performance standards provided by planning.
  • It also requires understanding responsibility for deviations from standards.

Control Techniques

  • Traditional techniques include budget and performance audits.
  • Audits involve examination and verification of records and documents.

Scope of Controlling

  • Goes beyond financial criteria to include production, operations, service delivery, and compliance with company policies.

Feedback

  • Definition: Information about the results of actions taken, used as a basis for improvement

  • Importance: Ensures continuous improvement and adaptation

  • Sources: Internal (staff, internal audits) and external (patients, regulatory bodies)

  • Enhancing decision-making and fostering a culture of continuous improvement

Feedback is essential for personal and professional growth. - It helps individuals understand their strengths and areas for improvement.

Types of Feedback

  • Constructive Feedback: Provides specific suggestions for improvement in a supportive manner.
  • Positive Feedback: Acknowledges and reinforces desirable behavior or outcomes.
  • Negative Feedback: Highlights areas for improvement or corrective action.

Principles of Effective Feedback

  • Timeliness: Feedback should be provided promptly after the observed behavior.
  • Specificity: Feedback should be clear, specific, and focused on behavior rather than personality.
  • Balance: Include both positive and negative feedback to provide a well-rounded perspective.
  • Actionable: Feedback should be actionable, providing concrete steps for improvement.
  • Respectful: Feedback should be delivered respectfully, maintaining dignity and professionalism.

Giving Feedback

  • Be Prepared: Organize your thoughts and observations before providing feedback.
  • Be Objective: Base feedback on observable behaviors and facts rather than assumptions or opinions.
  • Be Constructive: Offer solutions and suggestions for improvement rather than criticism.
  • Be Receptive: Encourage dialogue and listen to the recipient’s perspective.

Receiving Feedback

  • Be Open-Minded: Approach feedback with a willingness to learn and grow.
  • Seek Clarification: If feedback is unclear, ask for specific examples or further explanation.
  • Focus on Improvement: Use feedback as an opportunity for self-reflection and growth.
  • Express Appreciation: Thank the giver for their feedback, regardless of its nature.

Recap

Questions?

Thank You!

Steps of Planning Cycle

Introduction

Planning is the process that involves:

  1. defining a problem,
  2. assessing the extent to which the problem affects society,
  3. formulating goals to solve the problem,
  4. assessing various intervention measures based on their advantages and disadvantages,
  5. selecting the best mode of action,
  6. taking steps to implement it,
  7. monitoring the progress of the implemented system, and
  8. evaluating the results.

Steps of a Planning Cycle

Introduction to Planning

  • Planning involves defining a problem, assessing its impact, formulating goals, evaluating intervention measures, selecting the best action, implementing it, monitoring progress, and evaluating results.

  • Essential for achieving specific health goals and efficient resource use.

1: Analysis of the Situation

  • Step 1: Situational Analysis
    • Key Aspects to Study:
      • Population: age and sex structure
      • Morbidity and mortality values
      • Epidemiology and geographic distribution of the disease
      • Existing healthcare facilities
      • Available technical manpower
      • Training facilities for healthcare staff
      • Community awareness regarding the disease

2: Setting Objectives and Goals

  • Step 2: List out Objectives and Goals
    • Objectives must be clear to implement a plan efficiently.
    • Central level objectives are general; they become more specific at successive levels.

3: Assessment of Resources

  • Step 3: Assess Resources
    • Assess the available material, capital, and human resources.

4: Fixing Priorities

  • Step 4: Fix Priorities
    • Limited resources necessitate prioritizing goals.
    • Allocate resources to priority goals.

5: Writing the Plan

  • Step 5: Write up Formulated Plan
    • Develop a systematic plan to achieve prioritized goals.
    • Include major steps, required resources, and expected outcomes.

6: Programming and Implementation

  • Step 6: Programming and Implementation
    • Implement the approved plan with proper administrative support.
    • Even a good plan can fail if not properly implemented.

7: Monitoring

  • Step 7: Monitoring
    • Monitor the day-to-day functioning of the program.
    • Implement suggestions for improvement.

8: Evaluation

  • Step 8: Evaluation
    • Evaluate the final outcome of the plan.
    • A good plan includes an in-built evaluation system.

Summary

# Thank You!

Modern Management Techniques

Traditional Management Techniques

  • Personnel Selection
  • Training
  • Team Building
  • Motivation
  • Leadership Development etc

Modern Management Techniques

Developed Post World War - II

Rely on:

  • mathematics,
  • statistics,
  • economics etc.

Proved to be effective in multiple streams: business, industry, defence, etc.

Enable critical analysis of competing interests on scarce resources and priorities.

Emergence of Operations Research (OR)

Employs methods from mathematical modelling, statistical analysis, optimization techniques.

Provides optimal/near-optimal solutions for complex decision-making problems

Overlapping field of: - production engineering - operational management - organisational science

Father of Modern Management

Defining “Technique” or “Method”

Method

‘a manner or means of procedure’

Technique

‘a systematic procedure by which a complex or scientific task is accomplished’

Classification of Modern Management Techniques

  • Management by objectives
  • Management by results
  • Management by projects
  • Management by exception
  • Management by budget

Classification of Modern Management Techniques

  • Statistical Techniques
  • Activity Analysis
  • Mathematical Techniques
  • Financial Techniques
  • Miscellaneous

Statistical Techniques

  • Time Trends and Forecasting
  • Decision Theory and Decision Tree
  • Six Sigma

Activity Analysis

  • Time Motion Studies
  • Work Sampling and Activity Analysis
  • Queuing Theory
  • Gantt Chart and Work Schedule

Mathematical Techniques

  • Simulation Studies/Models
  • Systems Analysis
  • Linear Programming
  • Inventory Control
  • Network Analysis
  • Program Evaluation Review Technique (PERT)
  • Critital Path Method (CPM)

Financial Techniques

  • Budgeting
  • Cost Benefit Analysis
  • Cost Effectiveness Analysis
  • Planning - Programming - Budgeting System (PPBS)
  • Zero Base Budgeting

Miscellaneous

  • Situational Analysis
  • SWOT Analysis
  • Log-Frame Analysis